Pioneer Family Pharmacy #104

LBN: Pioneer Family Pharmacy Inc
Pioneer Family Pharmacy #104 is an health care organization with primary practice located at 412 N 5Th St , Roscommon MI 48653-9329. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Pioneer Family Pharmacy Inc can be contacted via phone (989) 275-5600, or through Braidwood, Richard via phone (989) 389-7277.

Contact Information

Primary practice address
412 N 5Th St Roscommon MI 48653-9329
Phone: (989) 275-5600
Fax: (989) 275-4707
Website:
Map and Directions
Authorized official contact:
Name: Braidwood, Richard RPH
Phone: (989) 389-7277

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 5301008443 Michigan

Profile Details

NPI number 1417064650
LBN Legal business name Pioneer Family Pharmacy Inc
DBA Doing business as Pioneer Family Pharmacy #104
Authorized official Braidwood, Richard RPH
Entity Organization
Organization subpart 1 No
Enumeration date Aug 24th, 2006
Last updated May 5th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417064650 NPPES
Michigan MEDICAID 2368668
Michigan Other 2042339

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